Can unconscious motives undermine transition consent?
After the Tavistock litigation, the authors argue that accepting medical transition to promote well-being is in someone’s best interests only if their transgender self-diagnosis is correct — and unconscious forces can undermine autonomy in children and adults.
Source
To be, or not to be? The role of the unconscious in transgender transitioning: identity, autonomy and well-being
What they did
They start from rising UK GID referrals, the December 2020 case of a patient who took puberty blockers at 16 then detransitioned, and capacity-to-consent worries. They then give a general argument about autonomy, well-being, and identity as subjective relative to the body.
What they found
Autonomy can be undermined by unconscious forces at any age. Best-interests endorsement of transition is biconditional on a correct self-diagnosis. Heterogeneity of transgender experience means definitions must be clarified before policy.
The limits
What it doesn't show
This is a normative argument, not a cohort of detransitioners. It does not estimate how often self-diagnosis is mistaken. The court case is context, not a new empirical finding of this paper.
Key terms
- Autonomy threat
- Unconscious forces that can undermine a request for medical transitioning, in children and adults.
- Best-interests iff
- Transitioning to promote well-being is in the person’s interests only if the transgender self-diagnosis is correct.
- Detransition
- Stopping or reversing a medical pathway, with physical and psychological complications.
- Tavistock GIDS
- UK specialist service for under-18s with gender dysphoria, site of the 2020 landmark litigation.
Flashcards
Research intelligence for this paper
See its role on concept claims, tensions it is part of, placement history, and related discoveries.
Quiz yourself
Autonomy worry applies to?
Common questions
Only a child issue?
No. They say the autonomy argument applies to children and adults.
When is accepting a request in someone’s interests?
Iff at the point of request their self-diagnosis as transgender is correct.
Why the court case?
It illustrates worries about puberty blockers, detransition, and capacity to consent.
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